Lewis Clair Brokaw, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

30012840 Issued in OH

Practice address

497 W Main St
Batavia, OH 45103-1727

Phone

(513) 735-9111

Fax

(513) 735-9222

NPI assigned

Nov 8, 2006

Last updated

Apr 7, 2008By the provider in NPPES

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Stephen J. Doelker DDS LLC

  dba Klermont 4 Kids & Adults 2

  • Dentist
  • Batavia, OH
  • NPI 1841301918
  NPD (past)
• Unique Solutions Management Company LLC

  dba Klermont 4 Kids & Adults 2

  • General Practice Dentistry
  • Batavia, OH
  • NPI 1578689295
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207526400000",
    "number": "1215007406",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "497 W MAIN ST",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451031727",
            "telephone_number": "513-735-9111",
            "fax_number": "513-735-9222"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "497 W MAIN ST",
            "city": "BATAVIA",
            "state": "OH",
            "postal_code": "451031727",
            "telephone_number": "513-735-9111",
            "fax_number": "513-735-9222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROKAW",
        "first_name": "LEWIS",
        "middle_name": "CLAIR",
        "name_prefix": "Dr.",
        "credential": "DDS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2008-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "OH",
            "license": "30012840",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2431150",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2231516",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Brickey
• Brightview LLC
• Maranda J Brock, RN
• Rebecca Brock, OTR/L
• Hannah Grace Brockman
• Tiffany Lynn Brondhaver
• Emily Brookbank, PA-C
• Michael Broussard
• Payton Brown
• Jennifer Brummell

• Dentist in Batavia, OH
• Providers in Batavia, OH by specialty
• Dentist in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.